Endorphin Pro 1, 2 and 3 and the latest Endorphin Elite even more have no real heel cup, just some soft material that has no pressure on the Achilles
Jeroen
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thank you!
Hi!
I am so sorry to hear about your AT, it’s a very frustrating injury.
Regarding the shoes, For me what helped was a low heel drop shoe (Saucony Kinvara) with a hard orthotic (Superfeet). The orthotics were recommended by a podiatrist, the shoe was trial and error. I also had heel bursitis with my midportion AT and the only relief was wearing Teva sandals. I never tried to run in them but I was tempted! I tried many shoes and the softer ones made things worse for me. This is not what most people report.
I also got mixed messages from doctors regarding what (activity) I could do. The best advice seemed to be that if it hurts the next day after doing something, you shouldn’t do that activity. My AT was so bad that I could only walk, no jogging at all. Swimming and some spinning were OK activities.
I hope this helps!
I am in the same boat… insertional Achilles tendonitis. It’s been plaguing me since June 2022.
I had the same thing 10 years ago, had a cortisone injection then (as you say, now widely frowned upon) and it cleared it right up. Couple weeks without running and I was then 9+ years trouble free afterwards.
But it cam back last year. Not much pain while running (but my form must have adapted to lower stress/pain, I’ve slowed down a lot on the run) but it stiffens and become in pain hours after a run and lasts for 1-1.5 days where I am somewhat limping.
At the end of last season, I took a full 3 months break from running hoping to get rid of it, saw a renowned physio here regularly for a year, did hours and hours of physio and exercises that are supposed to help this issue (eccentric heel lifts protocols), work on posture, lower back, etc.
→ P.S. Read this…worth including in your healing protocol: https://forum.slowtwitch.com/...ost=6553842#p6553842
When I started running again it came right back.
Did a short season, minimal running, miserable results.
Now starting another ~3 months without running to try to shake it.
Also planning to see if I can find someone to do an ultrasound guided cortisone injection in the coming weeks.
Finding several articles/studies that seems to conclude that the relation between cortisone injection and tendon rupture is not as common as one would think looking at data. Enough risk maybe to not use it without thought or as a first measure, but as a last resort, seems like 2-3 injections is pretty safe.
Good luck w your recovery! As someone else said, aim on the side of safety. If it just started, take a break from running to try to squash this early. Otherwise you can get stuck with it for a long time :-/
p.s. For walking around the house and in town, I love my Hoka recovery sandals… good support for the foot, open on the back - no pressure on the heel. otherwise I would recommend shoes with high toe-heel drop in addition to something not putting pressure on the back of your heel/foot.
When I started running, I used to have really bad bursitis in my heel (pump bump) and had so much rubbing (and pain), that I often wore through several layers of liner of the heel of the shoe all the way to the hard plastic heel casing - often in just a month or two. Nike Frees solved that problem completely for me. That was many years ago and I no longer have that heel issue as bad, but I still look for shoes that have a soft heel counter. But in my experience, Nike Frees were the only shoe I could find for 5-6 years that had a completely flexible heel counter that did not aggravate my heel at all.
→ P.S. Read this…worth including in your healing protocol: https://forum.slowtwitch.com/...ost=6553842#p6553842
this is really helpful and I think it is basically what my PT has me doing
I’m sorry you’re struggling with this too and I’m grateful to you for sharing your story.
Finding several articles/studies that seems to conclude that the relation between cortisone injection and tendon rupture is not as common as one would think looking at data. Enough risk maybe to not use it without thought or as a first measure, but as a last resort, seems like 2-3 injections is pretty safe.
Good luck w your recovery! As someone else said, aim on the side of safety. If it just started, take a break from running to try to squash this early. Otherwise you can get stuck with it for a long time :-/
it started in June; I didn’t try to run through it for very long (really - just a couple of days, and that was primarily because it took me those few days to figure out what it was, and then I realized I didn’t want to mess with it). I don’t have the pain-when-I-wake-up-in-the-AM which is good.
Interesting on the injections
wishing you the best. keep me updated. Really. PM me.
I had achilles surgery 6 days ago to hopefully resolve my insertional issues. Basically I had the exact same surgery as Galen Rupp by the same doctor. Removed a haglunds deformity and removed a ton of calcification from my achilles. Right now is the first time in 5 years my achilles feels no pain. But I have a very long recovery ahead.
I hope your achilles is feeling better.
I’m so glad you’re not in pain! I wish you the best in recovery.
I haven’t run in 16 days. The last time I ran (12 x 1 min very easy run with 1 min walk recoveries) I had some pain so I decided to shut it down and just swim mostly (I’ve biked a little). MRI on Thursday just to be absolutely sure this is just an insertional tendonitis issue.
So, I don’t really know how it’s doing. I never was in pain walking, it’s only been running or a little tenderness after strength (which the PT said was normal and ok). I’m grateful to not have pain walking.
Thanks for the well wishes. Keep me updated on your recovery, ok?
→ P.S. Read this…worth including in your healing protocol: https://forum.slowtwitch.com/...ost=6553842#p6553842
this is really helpful and I think it is basically what my PT has me doing
note I was able to manage my insertional pains for over a decade using that protocol -
3x30-45s heavy isometric straight leg heel raise. Use a barbell
I’d do this at least once a week, worked up to 45lb plate. The problem I think was that I was dropping too far down on the drop, which stretched the tendon too much and eventually aggravated the insertional problems rather than helping.
my doc wanted to give a cortisone shot, I refused it… he seemed to think there would not be any problems and the inflammation reduction would be helpful.
Another thing that helped in the worst phases, when I had trouble walking in the morning - slept in a boot, which keeps the foot in a slightly dorsiflexed position all night. It works great but now you’re sleeping with a boot on which is not great.
Jury’s still out on my new orthotics… ran 12 miles on Sun, and the heel became quite painful by the end. On the other hand there wasn’t much stiffness the next morning which is very unusual, normally would be limping for a day or two. I’m hoping it’s a break-in period and things may improve. There was a mama bear and cub, on the other side of the river… first time I’ve seen a bear during a run…
Plain old Dr Scholl heel lifts work surprisingly well otherwise, ran in those yesterday and minimal pain and hangover.
Never thought about the shoe pressure on the achilles, for some reason the shoes have never been an issue for mine, with the exception of stiff leather dress shoes which I hardly wear anyway.
Dr. Tigerchik wrote:
Quote:
→ P.S. Read this…worth including in your healing protocol: https://forum.slowtwitch.com/...ost=6553842#p6553842
this is really helpful and I think it is basically what my PT has me doing
note I was able to manage my insertional pains for over a decade using that protocol -
3x30-45s heavy isometric straight leg heel raise. Use a barbell
I’d do this at least once a week, worked up to 45lb plate. The problem I think was that I was dropping too far down on the drop, which stretched the tendon too much and eventually aggravated the insertional problems rather than helping.
my doc wanted to give a cortisone shot, I refused it… he seemed to think there would not be any problems and the inflammation reduction would be helpful.
Another thing that helped in the worst phases, when I had trouble walking in the morning - slept in a boot, which keeps the foot in a slightly dorsiflexed position all night. It works great but now you’re sleeping with a boot on which is not great.
Jury’s still out on my new orthotics… ran 12 miles on Sun, and the heel became quite painful by the end. On the other hand there wasn’t much stiffness the next morning which is very unusual, normally would be limping for a day or two. I’m hoping it’s a break-in period and things may improve. There was a mama bear and cub, on the other side of the river… first time I’ve seen a bear during a run…
Plain old Dr Scholl heel lifts work surprisingly well otherwise, ran in those yesterday and minimal pain and hangover.
Never thought about the shoe pressure on the achilles, for some reason the shoes have never been an issue for mine, with the exception of stiff leather dress shoes which I hardly wear anyway.
managing it isn’t something I’m interested in… it doesn’t seem like a super great idea to run when something is getting painful or be limping a day after a run. I’m not running right now, and am doing heel raises (no weights right now). Agree on not dropping the heel below parallel.
I hope you can get it gone for good.
0 drop shoes like Altra or topo.
by ‘managing’, I mean it was pain-free for most of that time… occasional returns of pain after bouts of ill-considered mountain running etc, with a return to pain-free running after a week or two of NSAIDs, appropriate exercise, etc.
then with age came increasing pains 